Olin Shelly J, Bartges Joseph W, Jones Rebekah D, Bemis David A
Department of Small Animal Clinical Science, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.
J Am Vet Med Assoc. 2013 Dec 15;243(12):1719-25. doi: 10.2460/javma.243.12.1719.
To determine diagnostic accuracy of a compartmented bacteriologic culture and antimicrobial susceptibility testing plate (CCSP) for detection of bacterial urinary tract infection (UTI) in dogs and antimicrobial susceptibility testing of bacterial isolates.
Evaluation study.
62 frozen, previously characterized bacterial isolates from canine urine cultures and 147 canine urine samples.
The study was conducted in 2 phases: preliminary assay validation (phase 1) and diagnostic validation (phase 2). For phase 1, the frozen bacterial isolates were revitalized and tested with the CCSP and with standard aerobic microbiological culture (SAMC). For phase 2, the urine samples were tested with the CCSP and SAMC in parallel.
For phase 1, after 24 hours of culture, 46 of 62 (74%) bacterial isolates had growth on the CCSP and all (100%) had growth in SAMC. For bacterial isolates with growth, the CCSP allowed correct identification of 45 of 46 (98%) isolates. Isolates yielding no growth on the CCSP were gram-positive cocci (Staphylococcus spp [n = 7] and Enterococcus spp [9]). In phase 2, the overall diagnostic accuracy of the CCSP, compared with SAMC, was 94% (sensitivity, 81%; specificity, 99%). The positive predictive value was 98% and negative predictive value was 92%. Susceptibility results for enrofloxacin and trimethoprim-sulfamethoxazole as determined with the CCSP had greatest concordance with those determined by SAMC (71% and 96%, respectively), compared with other antimicrobial susceptibilities.
Use of the CCSP led to accurate exclusion of UTI in dogs without a UTI but was less reliable for diagnosis of UTI, particularly infections caused by gram-positive cocci. Standard aerobic microbiological culture remains the gold standard for detection of UTI in dogs.
确定一种分区细菌培养及抗菌药敏试验平板(CCSP)用于检测犬细菌性尿路感染(UTI)及对分离细菌进行抗菌药敏试验的诊断准确性。
评估研究。
62株来自犬尿液培养物的冷冻、先前已鉴定的细菌分离株及147份犬尿液样本。
研究分两个阶段进行:初步试验验证(第1阶段)和诊断验证(第2阶段)。第1阶段,将冷冻的细菌分离株复苏,并分别用CCSP和标准需氧微生物培养(SAMC)进行检测。第2阶段,对尿液样本同时用CCSP和SAMC进行检测。
第1阶段,培养24小时后,62株细菌分离株中有46株(74%)在CCSP上生长,所有分离株(100%)在SAMC中生长。对于生长的细菌分离株,CCSP能正确鉴定46株中的45株(98%)。在CCSP上未生长的分离株为革兰氏阳性球菌(葡萄球菌属[n = 7]和肠球菌属[9])。第2阶段,与SAMC相比,CCSP的总体诊断准确性为94%(敏感性81%;特异性99%)。阳性预测值为98%,阴性预测值为92%。与其他抗菌药敏结果相比,用CCSP测定的恩诺沙星和甲氧苄啶-磺胺甲恶唑的药敏结果与SAMC测定的结果一致性最高(分别为71%和96%)。
使用CCSP可准确排除无UTI的犬的UTI,但对UTI的诊断可靠性较低,尤其是革兰氏阳性球菌引起的感染。标准需氧微生物培养仍是检测犬UTI的金标准。